Demographics and Characteristics of Acutely Decompensated Heart Failure (ADHF) Patients in a Tertiary Care Center in Saudi Arabia

Acute decompensated heart failure (ADHF) has been defined as the gradual or rapid change in heart failure (HF) signs and symptoms resulting in a need for urgent therapy. Patients with ADHF usually have multiple comorbidities that contribute to the severity of exacerbation at admission, including dia...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Curēus (Palo Alto, CA) CA), 2023-03, Vol.15 (3), p.e35724-e35724
Hauptverfasser: Alalawi, Hassan, Fida, Hamza L, Bokhary, Omar A, Alhuzali, Majed A, Alharbi, Abdullah F, Alhodian, Faisal Y, Alsahari, Mohammed R, Siddiqui, Aisha M
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page e35724
container_issue 3
container_start_page e35724
container_title Curēus (Palo Alto, CA)
container_volume 15
creator Alalawi, Hassan
Fida, Hamza L
Bokhary, Omar A
Alhuzali, Majed A
Alharbi, Abdullah F
Alhodian, Faisal Y
Alsahari, Mohammed R
Siddiqui, Aisha M
description Acute decompensated heart failure (ADHF) has been defined as the gradual or rapid change in heart failure (HF) signs and symptoms resulting in a need for urgent therapy. Patients with ADHF usually have multiple comorbidities that contribute to the severity of exacerbation at admission, including diabetes mellitus and chronic kidney disease. The prognosis for these individuals is generally poor, with a high risk of readmission and death after discharge. Unfortunately, there are limited studies in Saudi Arabia reporting the characteristics of such patients. We aim to study the demographics and characteristics of ADHF patients admitted to King Abdulaziz University Hospital (KAUH) and analyze gender discrepancies and in-hospital mortality. This retrospective record review was conducted at KAUH. The study included 425 patients diagnosed with ADHF. The New York Heart Association (NYHA) classification, underlying etiology of HF, comorbidities, left ventricular ejection fraction (LVEF), vital signs, comprehensive metabolic panel at admission, and in-hospital mortality were evaluated and analyzed. The majority of the patients were males (52.5%), and the average age was 63 ± 13.75 years. The most prevalent etiology of HF was hypertensive heart disease (51.8%), followed by ischemic heart disease (42.8%). The most common comorbidity was diabetes mellitus (73.6%), and the most common medication administered was diuretics (95.5%). The mean LVEF was 37.9% ± 16.0. In-hospital mortality occurred in 10.4% of patients. The mean length of hospitalization was 16.7 ± 86.2 days. The mean blood urea nitrogen (BUN) (17.18 ± 11.16) and creatinine (243.34 ± 222.27) were higher in patients with in-hospital mortality. The mean difference was statistically significant (P = 0.003 and P = 0.014). A higher length of hospitalization was significantly associated with in-hospital mortality (P = 0.036). We found more than half of our sample to be males and diabetes mellitus to be common among ADHF patients. Elevated BUN and creatinine levels at the time of presentation, as well as patients who had been in the hospital for a more extended period of time, were found to be associated with an increased risk of in-hospital mortality.
doi_str_mv 10.7759/cureus.35724
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10066922</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2796158184</sourcerecordid><originalsourceid>FETCH-LOGICAL-c343t-fb1d7b25a447a8dc5c9f22265b5d7a8b0ce5054321b5fb3658da4be79561129d3</originalsourceid><addsrcrecordid>eNpdkd1rFDEUxYMottS--SwBXyq4NcnkY-ZJllm3KxQqWJ_Dncydbsp8rEmm0Ef_c7NuW2qfEu75cTj3HkLec3ZujKq-uDngHM8LZYR8RY4F1-Wi5KV8_ex_RE5jvGWMcWYEM-wtOSoM41orcUz-rHCYbgLstt5FCmNL6y0EcAmDj2k_mzq6dHPC_p6u0E3DDscICVu6QQiJrsH3OQQ9W64260_0BySPY4rUjxToNYbkIdzTGjJSZwHDXvkJc-vpMkDj4R1500Ef8fThPSG_1t-u683i8urie728XLhCFmnRNbw1jVAgpYGydcpVnRBCq0a1edAwh4opWQjeqK4ptCpbkA2aSmnORdUWJ-TrwXc3NwO2LocJ0Ntd8ENOaCfw9n9l9Ft7M91ZzpjWlRDZ4ezBIUy_Z4zJDj467HsYcZqjFabSXO1PntGPL9DbaQ5j3s-KkplSSCl1pj4fKBemGAN2T2k4s_t-7aFf-6_fjH94vsET_Nhm8Rdw86Jb</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2807824446</pqid></control><display><type>article</type><title>Demographics and Characteristics of Acutely Decompensated Heart Failure (ADHF) Patients in a Tertiary Care Center in Saudi Arabia</title><source>PubMed Central</source><source>PubMed Central Open Access</source><creator>Alalawi, Hassan ; Fida, Hamza L ; Bokhary, Omar A ; Alhuzali, Majed A ; Alharbi, Abdullah F ; Alhodian, Faisal Y ; Alsahari, Mohammed R ; Siddiqui, Aisha M</creator><creatorcontrib>Alalawi, Hassan ; Fida, Hamza L ; Bokhary, Omar A ; Alhuzali, Majed A ; Alharbi, Abdullah F ; Alhodian, Faisal Y ; Alsahari, Mohammed R ; Siddiqui, Aisha M</creatorcontrib><description>Acute decompensated heart failure (ADHF) has been defined as the gradual or rapid change in heart failure (HF) signs and symptoms resulting in a need for urgent therapy. Patients with ADHF usually have multiple comorbidities that contribute to the severity of exacerbation at admission, including diabetes mellitus and chronic kidney disease. The prognosis for these individuals is generally poor, with a high risk of readmission and death after discharge. Unfortunately, there are limited studies in Saudi Arabia reporting the characteristics of such patients. We aim to study the demographics and characteristics of ADHF patients admitted to King Abdulaziz University Hospital (KAUH) and analyze gender discrepancies and in-hospital mortality. This retrospective record review was conducted at KAUH. The study included 425 patients diagnosed with ADHF. The New York Heart Association (NYHA) classification, underlying etiology of HF, comorbidities, left ventricular ejection fraction (LVEF), vital signs, comprehensive metabolic panel at admission, and in-hospital mortality were evaluated and analyzed. The majority of the patients were males (52.5%), and the average age was 63 ± 13.75 years. The most prevalent etiology of HF was hypertensive heart disease (51.8%), followed by ischemic heart disease (42.8%). The most common comorbidity was diabetes mellitus (73.6%), and the most common medication administered was diuretics (95.5%). The mean LVEF was 37.9% ± 16.0. In-hospital mortality occurred in 10.4% of patients. The mean length of hospitalization was 16.7 ± 86.2 days. The mean blood urea nitrogen (BUN) (17.18 ± 11.16) and creatinine (243.34 ± 222.27) were higher in patients with in-hospital mortality. The mean difference was statistically significant (P = 0.003 and P = 0.014). A higher length of hospitalization was significantly associated with in-hospital mortality (P = 0.036). We found more than half of our sample to be males and diabetes mellitus to be common among ADHF patients. Elevated BUN and creatinine levels at the time of presentation, as well as patients who had been in the hospital for a more extended period of time, were found to be associated with an increased risk of in-hospital mortality.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.35724</identifier><identifier>PMID: 37016652</identifier><language>eng</language><publisher>United States: Cureus Inc</publisher><subject>Anemia ; Angioplasty ; Blood pressure ; Body mass index ; Cardiology ; Cardiovascular disease ; Cholesterol ; Comorbidity ; Demographics ; Gender ; Heart failure ; Heart rate ; Hemoglobin ; High density lipoprotein ; Hypertension ; Internal Medicine ; Laboratories ; Lipoproteins ; Males ; Mortality ; Patients ; Peptides ; Potassium ; Pulmonary arteries ; Society ; Statistical analysis ; Triglycerides ; Vital signs</subject><ispartof>Curēus (Palo Alto, CA), 2023-03, Vol.15 (3), p.e35724-e35724</ispartof><rights>Copyright © 2023, Alalawi et al.</rights><rights>Copyright © 2023, Alalawi et al. This work is published under https://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2023, Alalawi et al. 2023 Alalawi et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c343t-fb1d7b25a447a8dc5c9f22265b5d7a8b0ce5054321b5fb3658da4be79561129d3</citedby><cites>FETCH-LOGICAL-c343t-fb1d7b25a447a8dc5c9f22265b5d7a8b0ce5054321b5fb3658da4be79561129d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10066922/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10066922/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37016652$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alalawi, Hassan</creatorcontrib><creatorcontrib>Fida, Hamza L</creatorcontrib><creatorcontrib>Bokhary, Omar A</creatorcontrib><creatorcontrib>Alhuzali, Majed A</creatorcontrib><creatorcontrib>Alharbi, Abdullah F</creatorcontrib><creatorcontrib>Alhodian, Faisal Y</creatorcontrib><creatorcontrib>Alsahari, Mohammed R</creatorcontrib><creatorcontrib>Siddiqui, Aisha M</creatorcontrib><title>Demographics and Characteristics of Acutely Decompensated Heart Failure (ADHF) Patients in a Tertiary Care Center in Saudi Arabia</title><title>Curēus (Palo Alto, CA)</title><addtitle>Cureus</addtitle><description>Acute decompensated heart failure (ADHF) has been defined as the gradual or rapid change in heart failure (HF) signs and symptoms resulting in a need for urgent therapy. Patients with ADHF usually have multiple comorbidities that contribute to the severity of exacerbation at admission, including diabetes mellitus and chronic kidney disease. The prognosis for these individuals is generally poor, with a high risk of readmission and death after discharge. Unfortunately, there are limited studies in Saudi Arabia reporting the characteristics of such patients. We aim to study the demographics and characteristics of ADHF patients admitted to King Abdulaziz University Hospital (KAUH) and analyze gender discrepancies and in-hospital mortality. This retrospective record review was conducted at KAUH. The study included 425 patients diagnosed with ADHF. The New York Heart Association (NYHA) classification, underlying etiology of HF, comorbidities, left ventricular ejection fraction (LVEF), vital signs, comprehensive metabolic panel at admission, and in-hospital mortality were evaluated and analyzed. The majority of the patients were males (52.5%), and the average age was 63 ± 13.75 years. The most prevalent etiology of HF was hypertensive heart disease (51.8%), followed by ischemic heart disease (42.8%). The most common comorbidity was diabetes mellitus (73.6%), and the most common medication administered was diuretics (95.5%). The mean LVEF was 37.9% ± 16.0. In-hospital mortality occurred in 10.4% of patients. The mean length of hospitalization was 16.7 ± 86.2 days. The mean blood urea nitrogen (BUN) (17.18 ± 11.16) and creatinine (243.34 ± 222.27) were higher in patients with in-hospital mortality. The mean difference was statistically significant (P = 0.003 and P = 0.014). A higher length of hospitalization was significantly associated with in-hospital mortality (P = 0.036). We found more than half of our sample to be males and diabetes mellitus to be common among ADHF patients. Elevated BUN and creatinine levels at the time of presentation, as well as patients who had been in the hospital for a more extended period of time, were found to be associated with an increased risk of in-hospital mortality.</description><subject>Anemia</subject><subject>Angioplasty</subject><subject>Blood pressure</subject><subject>Body mass index</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Cholesterol</subject><subject>Comorbidity</subject><subject>Demographics</subject><subject>Gender</subject><subject>Heart failure</subject><subject>Heart rate</subject><subject>Hemoglobin</subject><subject>High density lipoprotein</subject><subject>Hypertension</subject><subject>Internal Medicine</subject><subject>Laboratories</subject><subject>Lipoproteins</subject><subject>Males</subject><subject>Mortality</subject><subject>Patients</subject><subject>Peptides</subject><subject>Potassium</subject><subject>Pulmonary arteries</subject><subject>Society</subject><subject>Statistical analysis</subject><subject>Triglycerides</subject><subject>Vital signs</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNpdkd1rFDEUxYMottS--SwBXyq4NcnkY-ZJllm3KxQqWJ_Dncydbsp8rEmm0Ef_c7NuW2qfEu75cTj3HkLec3ZujKq-uDngHM8LZYR8RY4F1-Wi5KV8_ex_RE5jvGWMcWYEM-wtOSoM41orcUz-rHCYbgLstt5FCmNL6y0EcAmDj2k_mzq6dHPC_p6u0E3DDscICVu6QQiJrsH3OQQ9W64260_0BySPY4rUjxToNYbkIdzTGjJSZwHDXvkJc-vpMkDj4R1500Ef8fThPSG_1t-u683i8urie728XLhCFmnRNbw1jVAgpYGydcpVnRBCq0a1edAwh4opWQjeqK4ptCpbkA2aSmnORdUWJ-TrwXc3NwO2LocJ0Ntd8ENOaCfw9n9l9Ft7M91ZzpjWlRDZ4ezBIUy_Z4zJDj467HsYcZqjFabSXO1PntGPL9DbaQ5j3s-KkplSSCl1pj4fKBemGAN2T2k4s_t-7aFf-6_fjH94vsET_Nhm8Rdw86Jb</recordid><startdate>20230303</startdate><enddate>20230303</enddate><creator>Alalawi, Hassan</creator><creator>Fida, Hamza L</creator><creator>Bokhary, Omar A</creator><creator>Alhuzali, Majed A</creator><creator>Alharbi, Abdullah F</creator><creator>Alhodian, Faisal Y</creator><creator>Alsahari, Mohammed R</creator><creator>Siddiqui, Aisha M</creator><general>Cureus Inc</general><general>Cureus</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230303</creationdate><title>Demographics and Characteristics of Acutely Decompensated Heart Failure (ADHF) Patients in a Tertiary Care Center in Saudi Arabia</title><author>Alalawi, Hassan ; Fida, Hamza L ; Bokhary, Omar A ; Alhuzali, Majed A ; Alharbi, Abdullah F ; Alhodian, Faisal Y ; Alsahari, Mohammed R ; Siddiqui, Aisha M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c343t-fb1d7b25a447a8dc5c9f22265b5d7a8b0ce5054321b5fb3658da4be79561129d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anemia</topic><topic>Angioplasty</topic><topic>Blood pressure</topic><topic>Body mass index</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Cholesterol</topic><topic>Comorbidity</topic><topic>Demographics</topic><topic>Gender</topic><topic>Heart failure</topic><topic>Heart rate</topic><topic>Hemoglobin</topic><topic>High density lipoprotein</topic><topic>Hypertension</topic><topic>Internal Medicine</topic><topic>Laboratories</topic><topic>Lipoproteins</topic><topic>Males</topic><topic>Mortality</topic><topic>Patients</topic><topic>Peptides</topic><topic>Potassium</topic><topic>Pulmonary arteries</topic><topic>Society</topic><topic>Statistical analysis</topic><topic>Triglycerides</topic><topic>Vital signs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alalawi, Hassan</creatorcontrib><creatorcontrib>Fida, Hamza L</creatorcontrib><creatorcontrib>Bokhary, Omar A</creatorcontrib><creatorcontrib>Alhuzali, Majed A</creatorcontrib><creatorcontrib>Alharbi, Abdullah F</creatorcontrib><creatorcontrib>Alhodian, Faisal Y</creatorcontrib><creatorcontrib>Alsahari, Mohammed R</creatorcontrib><creatorcontrib>Siddiqui, Aisha M</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alalawi, Hassan</au><au>Fida, Hamza L</au><au>Bokhary, Omar A</au><au>Alhuzali, Majed A</au><au>Alharbi, Abdullah F</au><au>Alhodian, Faisal Y</au><au>Alsahari, Mohammed R</au><au>Siddiqui, Aisha M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Demographics and Characteristics of Acutely Decompensated Heart Failure (ADHF) Patients in a Tertiary Care Center in Saudi Arabia</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><addtitle>Cureus</addtitle><date>2023-03-03</date><risdate>2023</risdate><volume>15</volume><issue>3</issue><spage>e35724</spage><epage>e35724</epage><pages>e35724-e35724</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract>Acute decompensated heart failure (ADHF) has been defined as the gradual or rapid change in heart failure (HF) signs and symptoms resulting in a need for urgent therapy. Patients with ADHF usually have multiple comorbidities that contribute to the severity of exacerbation at admission, including diabetes mellitus and chronic kidney disease. The prognosis for these individuals is generally poor, with a high risk of readmission and death after discharge. Unfortunately, there are limited studies in Saudi Arabia reporting the characteristics of such patients. We aim to study the demographics and characteristics of ADHF patients admitted to King Abdulaziz University Hospital (KAUH) and analyze gender discrepancies and in-hospital mortality. This retrospective record review was conducted at KAUH. The study included 425 patients diagnosed with ADHF. The New York Heart Association (NYHA) classification, underlying etiology of HF, comorbidities, left ventricular ejection fraction (LVEF), vital signs, comprehensive metabolic panel at admission, and in-hospital mortality were evaluated and analyzed. The majority of the patients were males (52.5%), and the average age was 63 ± 13.75 years. The most prevalent etiology of HF was hypertensive heart disease (51.8%), followed by ischemic heart disease (42.8%). The most common comorbidity was diabetes mellitus (73.6%), and the most common medication administered was diuretics (95.5%). The mean LVEF was 37.9% ± 16.0. In-hospital mortality occurred in 10.4% of patients. The mean length of hospitalization was 16.7 ± 86.2 days. The mean blood urea nitrogen (BUN) (17.18 ± 11.16) and creatinine (243.34 ± 222.27) were higher in patients with in-hospital mortality. The mean difference was statistically significant (P = 0.003 and P = 0.014). A higher length of hospitalization was significantly associated with in-hospital mortality (P = 0.036). We found more than half of our sample to be males and diabetes mellitus to be common among ADHF patients. Elevated BUN and creatinine levels at the time of presentation, as well as patients who had been in the hospital for a more extended period of time, were found to be associated with an increased risk of in-hospital mortality.</abstract><cop>United States</cop><pub>Cureus Inc</pub><pmid>37016652</pmid><doi>10.7759/cureus.35724</doi><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 2168-8184
ispartof Curēus (Palo Alto, CA), 2023-03, Vol.15 (3), p.e35724-e35724
issn 2168-8184
2168-8184
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10066922
source PubMed Central; PubMed Central Open Access
subjects Anemia
Angioplasty
Blood pressure
Body mass index
Cardiology
Cardiovascular disease
Cholesterol
Comorbidity
Demographics
Gender
Heart failure
Heart rate
Hemoglobin
High density lipoprotein
Hypertension
Internal Medicine
Laboratories
Lipoproteins
Males
Mortality
Patients
Peptides
Potassium
Pulmonary arteries
Society
Statistical analysis
Triglycerides
Vital signs
title Demographics and Characteristics of Acutely Decompensated Heart Failure (ADHF) Patients in a Tertiary Care Center in Saudi Arabia
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-13T23%3A21%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Demographics%20and%20Characteristics%20of%20Acutely%20Decompensated%20Heart%20Failure%20(ADHF)%20Patients%20in%20a%20Tertiary%20Care%20Center%20in%20Saudi%20Arabia&rft.jtitle=Cur%C4%93us%20(Palo%20Alto,%20CA)&rft.au=Alalawi,%20Hassan&rft.date=2023-03-03&rft.volume=15&rft.issue=3&rft.spage=e35724&rft.epage=e35724&rft.pages=e35724-e35724&rft.issn=2168-8184&rft.eissn=2168-8184&rft_id=info:doi/10.7759/cureus.35724&rft_dat=%3Cproquest_pubme%3E2796158184%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2807824446&rft_id=info:pmid/37016652&rfr_iscdi=true